How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier None Typical Low $112.20 Median $5,011.87 Typical High $7,244.36 | Facility | None | $112.20 | $5,011.87 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $109.65 Median $1,230.27 Typical High $1,548.82 | Professional | None | $109.65 | $1,230.27 | $1,548.82 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,041.74 Median $5,495.41 Typical High $21,877.62 | Facility | None | $2,041.74 | $5,495.41 | $21,877.62 |
Anthem BCBS Setting Professional Modifier None Typical Low $74.13 Median $316.23 Typical High $1,659.59 | Professional | None | $74.13 | $316.23 | $1,659.59 |
CareSource Setting Facility Modifier None Typical Low $93.33 Median $97.72 Typical High $5,248.07 | Facility | None | $93.33 | $97.72 | $5,248.07 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $3,090.30 Typical High $5,128.61 | Facility | None | $630.96 | $3,090.30 | $5,128.61 |
Cigna Setting Professional Modifier None Typical Low $102.33 Median $371.54 Typical High $2,290.87 | Professional | None | $102.33 | $371.54 | $2,290.87 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $257.04 Median $4,466.84 Typical High $6,760.83 | Facility | None | $257.04 | $4,466.84 | $6,760.83 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $109.65 Median $245.47 Typical High $2,137.96 | Professional | None | $109.65 | $245.47 | $2,137.96 |
United Setting Facility Modifier None Typical Low $1,202.26 Median $4,570.88 Typical High $12,022.64 | Facility | None | $1,202.26 | $4,570.88 | $12,022.64 |
United Setting Professional Modifier None Typical Low $102.33 Median $1,096.48 Typical High $2,951.21 | Professional | None | $102.33 | $1,096.48 | $2,951.21 |
5 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $54.95 Median $616.60 Typical High $776.25 | Professional | 52 · Reduced service | $54.95 | $616.60 | $776.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $21.88 Median $245.47 Typical High $309.03 | Professional | 53 · Discontinued | $21.88 | $245.47 | $309.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $81.28 Median $933.25 Typical High $1,174.90 | Professional | 54 · Surgery only | $81.28 | $933.25 | $1,174.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.60 Median $186.21 Typical High $234.42 | Professional | 55 · Aftercare only | $16.60 | $186.21 | $234.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.96 Median $123.03 Typical High $154.88 | Professional | 56 · Pre-op care only | $10.96 | $123.03 | $154.88 |
Where Indiana sits
The same service costs 19.1 times more in Alaska than in Nebraska. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
Indiana· 35th of 51
$1,380
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.